Rohlffs Fiona, Tsilimparis Nikolaos, Fiorucci Beatrice, Heidemann Franziska, Debus Eike Sebastian, Kölbel Tilo
1 German Aortic Center Hamburg, Department of Vascular Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
2 Unit of Vascular and Endovascular Surgery, Hospital S. Maria della Misericordia, University of Perugia, Italy.
J Endovasc Ther. 2017 Aug;24(4):549-555. doi: 10.1177/1526602817709252. Epub 2017 May 11.
To describe the technical aspects and early results of the Candy-Plug technique for endovascular false lumen occlusion in chronic aortic dissection.
A retrospective single-center study analyzing 18 consecutive patients (mean age 63 years, range 44-76; 16 men) with thoracic false lumen aneurysm in chronic aortic dissection. All patients underwent thoracic endovascular aortic repair with false lumen occlusion using the Candy-Plug technique. Primary endpoints consisted of technical success (successful deployment) and clinical success (no false lumen backflow). Secondary endpoints included 30-day mortality and morbidity as well as aortic remodeling during follow-up.
Technical success was 100%. Additional intraprocedural false lumen embolization at the Candy-Plug level was needed in 1 patient due to persisting false lumen backflow on the final angiogram (clinical success 94%). There were no intraprocedural complications. In the perioperative period, there were 3 minor complications: transient mild spinal cord ischemia, cervical hematoma after carotid-subclavian bypass, and a common femoral artery pseudoaneurysm. No deaths or reinterventions occurred. Complete distal false lumen occlusion was present on postoperative computed tomography in 15 patients, while 3 had minor contrast enhancement in the distal false lumen. Over a mean 9-month follow-up (range 0-26), 1 patient died due to rupture. Follow-up >6 months was available in 10 patients (mean 14.7 months, range 7-26): 7 patients showed aortic remodeling, while aneurysm size was stable in 3 patients.
The Candy-Plug technique is a feasible endovascular method to achieve false lumen occlusion and aortic remodeling in chronic aortic dissection. It is associated with low morbidity and mortality due to its minimal invasiveness.
描述用于慢性主动脉夹层血管内假腔闭塞的Candy-Plug技术的技术要点和早期结果。
一项回顾性单中心研究，分析18例连续的慢性主动脉夹层胸段假腔动脉瘤患者（平均年龄63岁，范围44 - 76岁；16例男性）。所有患者均采用Candy-Plug技术行胸段血管内主动脉修复术并闭塞假腔。主要终点包括技术成功（成功植入）和临床成功（无假腔逆流）。次要终点包括30天死亡率和发病率以及随访期间的主动脉重塑情况。
技术成功率为100%。1例患者因最终血管造影显示假腔持续逆流，需要在Candy-Plug水平进行额外的术中假腔栓塞（临床成功率94%）。术中无并发症发生。围手术期有3例轻微并发症：短暂性轻度脊髓缺血、颈动脉 - 锁骨下动脉旁路术后颈部血肿以及股总动脉假性动脉瘤。无死亡或再次干预情况发生。15例患者术后计算机断层扫描显示远端假腔完全闭塞，3例患者远端假腔有轻微造影剂增强。平均随访9个月（范围0 - 26个月），1例患者因破裂死亡。10例患者随访时间>6个月（平均14.7个月，范围7 - 26个月）：7例患者显示主动脉重塑，3例患者动脉瘤大小稳定。
Candy-Plug技术是一种可行的血管内方法，可实现慢性主动脉夹层的假腔闭塞和主动脉重塑。因其微创性，其发病率和死亡率较低。
